THE “CREEPING” COST OF CUTS BY MARTA SILAKKA RN, BSN, CCM, COHN-S NURSE CASE MANAGER NHADA — WCT Over the years — 23 to be exact — I have written many articles for our members on topics related to the need to seek medical treatment, the “who,” “what,” “where” and “when” of treating workplace injuries and the cost of medical care, just to name a few. I reviewed these past articles to see what has changed other than the date and the letters after my name. I was completely blown away by what I saw! The NHADA Workers’ Compensation Trust (WCT) sees literally hundreds of claims for minor cuts, scrapes, lacerations and puncture wounds. That statistic has not changed. The cost of these claims, however, has gone up exponentially. Based on this, it is time for some new information. It’s time for a review as to why being frugal when it comes to medical care is not the path to take and also a reminder of how something small can turn into something HUGE. In the automotive industry, it is not uncommon for someone to get minor cuts and scrapes on a day-to-day basis; most are an easy washing, antibiotic ointment and a Band-Aid and then back to work. This is the best-case scenario; unfortunately, not all simple cuts end with a Band-Aid. There is a lot to consider with work injuries, no matter how small. Remember, no matter how clean and great the shops look, the automotive industry can be a bit dirty. When a work injury occurs, a call should be placed to us; of course, in the event of a true life-threatening injury, always call 911 first and follow up with us afterward. When it is not life-threatening, the call to us will assist the injured worker in getting the most appropriate level of medical care and, in the long run, will avoid medical complications and save money. So, a simple cut has occurred at work; what now? • What To Consider ⊲ Is formal medical treatment really necessary? Calling NHADA-WCT and speaking to the nurse case manager gives the employer/employee and the nurse a chance to review the injury and determine if treatment is needed or if simple first aid at the workplace will do the trick. ⊲ Are sutures needed? When a cut occurs, a “timer” starts ticking. There is a window in which sutures can be placed to ensure appropriate healing. Missing this window could lead to poor healing, scarring and infection. Not sure if it’s that bad? Consider the alternative: avoiding a quick urgent care vs. multiple visits for an infected wound. ⊲ Is a tetanus shot needed? Most people cannot remember when they got their last tetanus shot. During annual physicals with our primary care provider, it will typically be addressed. Most adults get a tetanus shot every 5-10 years. These avoid complications from breaks to the skin that introduce bacteria and put you at risk. Not sure when you had one and have a minor cut or scrape; it’s best to be seen so a medical provider can determine if a tetanus shot is necessary. ⊲ Is the cut small but deep? A common misconception is a small cut or puncture wound that is deep is too small to suture, so why seek treatment? In this case, treatment is absolutely necessary. Deep cuts can damage muscle and even bone. Antibiotics most likely are needed to avoid serious infections from deep cuts. ⊲ Is it OK to just wait and see how it looks later? So many times, injured workers just do not want to take the time to get something that appears minor addressed. They are busy at work, they may be embarrassed to tell someone they got hurt and some feel they do not want their employer to incur costs for their treatment. Others just simply want to take the wait-and-see approach, and maybe they don’t need to go to the doctor. This is absolutely the worst route to take. The most minor cut can lead to complications that could include infection, scarring, loss of function and, in the most extreme but not completely unlikely scenario, amputation. • What Not To Consider ⊲ Skipping the call to the nurse because the employee or employer thinks it is so minor that nothing can come of it … because something will come of it. 20
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